Intimidated by the thought of learning vag exams...help!

palesarah · May 17, 2005

it can take a while to "get it", and that's OK. When you're starting out, anything that's round with a hole- close your eyes, and use your fingers to feel the inside diameter. Compare against a measuring tape. That's one trick. Or you can find things that are 1cm, 2cm, etc, and practice the same way. I've only been a nurse for 2 years, I still need to check against the dilation chart for anything between 4-7cm! 4-5, 6-7, it gets a little muddled. (and really, is it that important? not usually)

Starting out I knew long/thick/closed, fingertip, 4, and fully. I still measure 7cm to fully by how much cervix is left around the edge versus the diameter. I can't stretch my fingers that far apart!

Trust me, you're not the only 'fraidy cat here. It's a skill that takes time to learn. Some people get it right away, some take longer. Going to "midwifery boot camp" in El Paso, you're going to have to learn it sooner. I have a friend who is a NH licensed midwife who went to Casa to get her all her catches in to qualify. She said that staff are really tough on the interns but it was worth it

babyktchr, BSN, RN · May 18, 2005

This too shall pass honey. Practice practice practice. It takes time, but you will get it. The more you do it...the better it becomes. That is the only advice that I can give you. When I started out in OB...I checked everyone that came in to be evaluated..even if I was assigned elsewhere. Gave me the experience with different dilations and effacements and was a good thing for me.

Good luck to you in your career path...

Pixie Dust · May 18, 2005

Since you are a visual person, go to pocketdilationguide.com and check this out. This is a guide you can get and use at home (with your eyes closed) before you ever start doing exams. You'll at least know what you are supposed to be feeling when you get there and have a little more confidence. It also has an effacement measurment on the back in centimeters. It gives just a little sense of security when first learning to do exams and it's something you can keep with you at all times while working. Believe me, since it is a blind exam and we as nurses want to do things well, we all question what we are feeling from time to time. Thank goodness most patients keep on moving forward with their dilation so we don't have to question our exams often.

BabyRN2Be · May 18, 2005

As palesarah mentioned, use the dilitation charts if you are a visual person (like myself, so I know where you are coming from). Spend time practicing with it so you can translate the visual to the tactile easier.

It's great to meet another doula who is going to be an RN! :)

madwife2002, BSN, RN · May 18, 2005

Hey i qualified as a midwife in Uk and it wasn't until then that I knew what I was looking for :chuckle (did 18 months post RN training as a speciality)

I had my first labourer and nobody to check after me so I had to find it, found the cervix and once you find it the first time you will never not find it again. I believe I was feeling the lady partsl wall all the other VE's I did and it was sheer luck if I got the dilatation the same as my mentor. I used to pray please let her be fully beacuse that was easier to diagnose LOL :chuckle or fully closed uneffaced central cervix even easier.

Have hope you will do it!!!

Natalieboo · May 18, 2005

onehusbandsevenkids & BabyRN2Be: I'm a doula looking to get into nursing as well! Nice to see others here.

Honestly, I can't wait to perform lady partsl examinations! Sounds funny, but I know it will be something I am good at. For me it seems to be a very intuitive skill, and I've always been great with my hands. I checked my own cervix through a lot of my last pregnancy. I was right with all of my measurements. I seem to really have a knack for everything involving pregnancy, labor and birth and would go for midwifery school but in the end I don't want to give up my life to midwifery.

As a doula I've listened very closely and observed when a vag exam has been done. It may be coincidence, but I worked with one midwife twice who never could get the cervix on either of the clients and they both ended up with sections! Inside, I feel like if only I had the license could I have been any help.

Remember to be compassionate, respectful and gentle to the woman. In our community I know there is a group of doulas and other Child birth professionals who teach docs how to be kinder with vag exams, especially to women who have been sexually abused. But that's a whole other ball of wax.